Mental health and legal problems are interlinked in many ways. People facing legal issues may develop mental health problems, and people with mental illness and family also face legal issues. In India, Legal Services Authorities Act, 1987 gives provision for free legal aid services for the poor sections of society. Authors explain the roles of psychiatric social workers in legal aid services in hospitals. Social case work as a method of social work is suitable in legal aid services. Counseling, referrals, collateral contacts, advocacy and networking are major services from the social work perspective. Knowledge about laws and mental illness is essential for social workers to work in legal aid clinics (LACs).

The biopsychosocial (BPS) approach proposed by Engel four decades ago was regarded as one of the most important developments in medicine and psychiatry in the late 20^th century. Unlike the biomedical model, the BPS approach posits that biological, psychological, and social factors play a significant role in disease causation and treatment. This approach brought about a new way of conceptualizing mental health difficulties and engendered changes within research, medical teaching and practice. Global mental health (GMH) is a relatively new area of study and practice that seek to bridge inequities and inequality in mental healthcare services provision for people worldwide. The significance of the BPS approach for understanding mental health difficulties is being debated in the context of GMH initiatives. This paper critically evaluates strengths and weaknesses of the BPS approach to mental health difficulties and explores its relevance to GMH initiatives.

Background: Internet communication applications have become an important social context for the development of adolescents. The use of Internet is leading to many risk-taking behaviors also. Material and Methods: This study assessed the risk-taking behaviors and related problems among adolescents while using the internet and parental supervision on it. The study followed descriptive cross-sectional research design and the data was collected from 179 school going adolescents through semi-structured interview schedule. Results: About 60% of the respondents belonged to male (M = 14.5, SD = 1.2 years), mean time spent on internet use in the previous week was 6 hours, 41% access to computers at home, and 28% had arguments with their care givers due to their pattern of usage of internet. There was a significant difference in emotional (t = 3.127, df = 177, P < 0.01) and personal level risk-taking domains (t = 3.037, df = 177, P < 0.01) between male and female respondents, indicating boys were taking more risks than girls. High emotional problems among 8th grade students (M = 1.63, ±1.87) was noted. Significant difference was observed between the number of hours spent on online in a week and arguments with parents (t = 2.517, df = 177, P < 0.05). There was also significant difference in emotional problems (F = 3.212, P < 0.05) and sex-related risk (F = 4.735, P < 0.05) domains between parental filtering and non-filtering group (F = 3.212, P < 0.05). Conclusion: Results clearly indicate that there is an evidence of risk-taking behaviors among adolescents those who were in lack of parental supervision. Hence, there is an urgent need to educate parents, teachers, and address this issue on a greater scale including at the policy level.

Background: Internet has become an essential part of our daily life, especially among adolescents and youth. It is mainly used for education, entertainment, social networking, and information sharing. Its excessive use among health care providers is becoming a major concern. Aims: The aim of our study was to estimate the prevalence, understand the pattern, and to determine the association between psychopathology and internet addiction among health profession undergraduates. Materials and Methods: A cross-sectional study was conducted among 846 students of various faculties from Deemed University. Students were assessed with semi-structured data, Internet Addiction Test and Mental Health Inventory, after giving them brief instructions. Students were classified into normal students and addicted students for comparison. Results: The total prevalence of internet addiction was 19.85%, with moderate and severe addiction being 19.5% and 0.4%, respectively. Internet addiction was associated with gender, computer ownership, preferred time of internet use, login status, and mode of internet access (P < 0.05). It was also associated with anxiety, depression, loss of emotional/behavioral control, emotional ties, life satisfaction, psychological distress, and lower psychological well-being (P < 0.05). Conclusion: Significant association was found between psychopathology and internet addiction. Male gender, login status, emotional ties, and psychological distress were found to be important predictors of internet addiction among students. Hence, these parameters should be taken into consideration while promoting awareness of problematic internet use and educating students regarding healthy internet use.

Background: Study of emotion regulation strategies used by youth becomes necessary in the background of the high prevalence of emotional disorders in this population. This study examined emotion regulation and psychological problems among college youth as well as the relationship between the two. Methodology: Four hundred and nineteen students, who were divided into two groups (older adolescents, aged 16-17 years - group 1, n = 217; young adults aged 18-25 years - group 2, n = 202) participated in this exploratory study. Results: Predominantly positive emotion regulation strategies were used by group 1 (positive refocusing, refocus on planning, and positive reappraisal, respectively). The sample as a whole used more positive strategies (positive refocusing: 82% and 64% and refocus on planning: 93% and 87% in groups 1 and 2, respectively). Significant correlations between emotion regulation strategies (CERQ) and psychological problems (YSR/YASR) were found, thereby indicating that negative emotion regulation strategies were associated with psychological problems and vice versa. Females were found to have more of anxiety problems as opposed to males with more of conduct problems. However with increase in age, increase in the percentage of psychological problems and usage of negative emotion regulation strategies was observed. Conclusion: The findings of the present study contribute to understanding the patterns of emotion regulation in various emotional disorders. Findings could also contribute to developing an intervention program to help students having difficulty in regulation of their emotions.

Background: The study was undertaken as there is very less literature related to sources of influence for sexual knowledge and attitude toward sex and sexual behaviors of youth in India. Aim: The objectives of the study were to explore sexual knowledge, attitudes, behaviors and the sources of influence and also to examine the relationship between sexual knowledge, attitude and behaviors in the youth. Method: The sample was selected from colleges using purposive sampling method and from the community using snowball method (n = 300). The tools used were sociodemographic data sheet, Sexual Knowledge and Attitude Questionnaire (SKAQ-II) and Sexual Behavior and Sources of Influence (SBSI) scale. Results: Descriptive statistics and correlation was done to analyze the data. The youth had poor sexual knowledge; there was positive relationship between sexual knowledge and attitudes. Sexual behaviors through media and with self or others were found to be low. Internet was found to be the major source for gathering information and was considered the most reliable source. Conclusion: Indian college youth continue to have poor sexual knowledge. Internet is a major source of information and is considered as the most reliable one among youth. More knowledge about sex is associated with liberal attitude toward sex.

Background and objectives: Despite the huge burden of tobacco use or addiction, there has been a glaring scarcity of resources to tackle the problem. Although some of the tobacco users want to quit, very few have the opportunity to seek help from available treatment facilities. The study aimed to find out the profile of treatment seekers from clinic and community programs and also to compare the two groups. Method: This is a cross sectional, retrospective study of subjects enrolled in the clinic and various community outreach programs of a Tobacco Cessation Centre from the year 2002-2011. Modified intake form developed by the WHO was administered to the subjects. Results: Significant difference was found between the two groups with regard to the age of treatment seeking, education and socio economic status. Older subjects reported in greater numbers to the clinic, whereas younger subjects belonged to the community group. Community group had lower level of education, belonged to lower or upper lower socio economic status whereas clinic group had higher level of education and were from the middle or upper socio economic status. Curiosity (Z score = 3.2,P = 0.001) played a significant role in initiating the use in clinic group whereas role model (Z score = 5.1, P = <0.0001) and low self esteem (Z score = 2.0, P = 0.023) were significantly associated with community sample. Presence of medical complications (Z score = 12.5, P = <0.0001), awareness of physical harm of nicotine (Z score = 5.0, P = <0.0001) and awareness of addiction was significantly more in the clinic group. Interpretation and Conclusions: The difference in the socio-demographic and clinical profile of tobacco users in these two treatment groups is noteworthy, and is expected to offer useful information for the clinicians and as well as for the policy makers.

Context: There is a lack of literature on the relation between psychiatric comorbidities and their influence on quality of life in patients with alcohol dependence syndrome in the Indian settings. Aims: To study the relation between psychiatric comorbidity with quality of life in patients with alcohol dependence. Settings and Design: The study was carried out in a de-addiction centre of a tertiary care hospital upon randomly selected inpatients of alcohol dependence syndrome. Patients with other substance abuse except tobacco or those with severe physical impairment were excluded. Materials and Methods: Hundred in-patients were assessed between the period of August 2013 to July 2014, using a number of instruments including specially designed proforma for clinical and drinking variables, CIWA-Ar, SADD, M.I.N.I 5.0 and WHO QoL Bref. Statistics used: SPSS 19.0 was used for analysis. Significance was calculated using t-test for continuous variables and chi-square test for categorical variables. Results: Prevalence of psychiatric disorder was found to be 32% across all the tested patients, with anxiety (n = 13) and depressive disorder (n = 12) being most common. Presence of psychiatric comorbidity lead to significant lowering in overall quality, perception of general health, physical (42.12 vs 57.78, P = 0.001), psychological (40.19 vs 53.29, P = 0.002), social (43.97 vs 66.90, P = 0.000), and environment (50.47 vs 62.71, P = 0.001) domains. Conclusion: Comorbid psychiatric disorders have a significant negative impact on the quality of life in patients with alcohol dependence syndrome.

Background/Objectives: Orphanages are emerging as an important source of care and child-raising for the ever-increasing number of orphans in the conflict-ridden Kashmir. These children are generally prone to develop psychiatric disorders even reared in well run institution. Objective is to highlight the psychosocial differences in children living in orphanages of Kashmir with and without psychiatric morbidity. Materials and Methods: Cross-sectional descriptive study was carried out where 348 children were recruited from eight registered orphanages of Srinagar, Jammu and Kashmir. Semistructured questionnaire was used to collect data related to sociodemographic profile of the children. Development and Well-Being Assessment (DAWBA) was used for one stage structured assessment of psychopathology. Data analysis was done by Statistical Package for Social Sciences for windows 20.0 version. Results: A total of 97.87% among those having psychiatric morbidity were males as against those without psychiatric morbidity where 28.99% were females. While 8.51% among those having psychiatric morbidity were double orphans, it formed only 1.45% of those without psychiatric morbidity. Likewise 25% among those having psychiatric morbidity had parental deaths due to fire-arm injury, while only 11.67% of them fall in the group without psychiatric morbidity. Among the group with psychiatric morbidity 31.91% had spent less than a year in an orphanage and 10.64% had spent ≥ 9 years as against those without morbidity where percentages were 14.49% and 4.35%, respectively. While 21.28% among those with psychiatric morbidity were enrolled in high education, it formed only 13.04% of those without psychiatric morbidity. Gender, type of orphan, length of stay, cause of parental death, and grade (education level) were significantly associated with the psychiatric morbidity (40.52%). Conclusion: The psychosocial differences in children with and without psychiatric morbidity may help in understanding the factors associated with the emerging psychopathology. Early timely intervention to the children especially “at risk” can be provided to alleviate their mental health problems.

Background: Fungal infections of nose and paranasal sinuses have a protracted course with frequent relapses and recurrences. Quality of life (QOL) of such patients is severely affected. Materials and Methods: The aim of this study was to assess QOL of patients with fungal infection of nose and paranasal sinuses. The objective was to assess disease specific QOL, health-related QOL, and global QOL. Cross sectional assessment was carried out on thirty patients with the diagnosis of fungal infection of nose and paranasal sinuses. Results: The total Sino Nasal Outcome Test score was indicative of “moderate degree of problem.” Regarding generic QOL, as assessed using WHOQOL-Bref, the sample had overall moderate QOL in all domains. On the contrary, on the Short Form-36, highest scores were obtained on the individual domains of “physical functioning” and “pain” with lowest scores on the domains of “general health” and “role limitation due to physical health.” Conclusion: It can be concluded that Indian patients with fungal infection of paranasal sinuses report moderate degree of QOL on both disease specific (SNOT-20) and global (WHOQOL-Bref) scales with mild to moderate limitation on health-related QOL scale (SF-36).

Child and adolescent mental health issues have a wide prevalence and cause serious burden and stress to the psychosocial health of parents and caregivers. Psychosocial interventions have proved to be useful adjuncts to pharmacological treatment in childhood psychiatric conditions because of their long standing nature and psychosocial implications. The present paper aims to identify and enlist the benefits of one such group-based parenting program practiced in a mental health services inpatient setting. The paper borrows from the experiences and observations of a psychiatric social worker who has considerable experience in conducting such group sessions. The material recorded here helps in understanding that parents and caregivers perceive benefits of significant magnitude from regular group session inputs, which help them to deal with the mental health issues of their children, and which also turn out to be a source of support.

Background: Resilience building interventions are gaining popularity, and the same needs to be enforced. However, considering the effectiveness of a programme after a need assessment, understanding the extent of resilience and the related construct of perceived social support (PSS) becomes imperative. Hence, this study aimed at assessing the resilience and PSS among school-going adolescents. Objectives: The objectives of the study were to assess the Perceived Stress, PSS, to understand the gender differences in level of PSS and resilience among school going adolescents in Mangaluru city of Southern India. Materials and Methods: A cross- sectional descriptive research design was used. School-going adolescents from grades 8^–10^th of the four schools of Mangaluru city were selected through convenient sampling (n = 206). Data were collected through self-administered scales. Descriptive statistics and t-test were applied. Results: The mean age of the study sample was 14.10 (±0.896) years. Adolescents had mild level of perceived stress, high PSS, and moderate resilience. Significant difference was noted between boys and girls in the global PSS and PSS from friends and significant others and resilience. Conclusions: The moderate resilience highlights the scope for resilience building programmes in schools of Mangaluru. Furthermore, the gender differences in the measured competencies indicate the need to develop gender-specific intervention packages.

Background: Internship is an important phase in medical students' training, which can have a bearing on the attitude they develop towards various specialties and illnesses. Very few studies have tried to assess the effect of clinical rotation on the attitude of interns towards Psychiatry. This study was planned to assess the same before and after a 2 week posting in Psychiatry. Aims: To study the change in the attitude of interns towards psychiatry before and after clinical rotation in Psychiatry. Methods: The study sample comprised of 60 interns in a tertiary care teaching hospital. Medical Condition Regard Scale (MCRS) was used to assess the attitude of interns towards Psychiatry before and after a 2 week Psychiatry rotation. Non-parametric tests were used to analyze the data obtained. Results: Many individual items and the overall scores of MCRS showed significant improvement for both psychiatric illness and alcohol and drug dependence after the 2 week Psychiatry rotation. Increase in MCRS score indicates improvement in the attitude towards Psychiatry. Conclusions: The attitude of interns towards Psychiatry improved following a 2 week clinical rotation in Psychiatry. Further studies are needed to better understand the factors that may influence the attitude of interns.

Background: Medical education is inherently stressful. Postgraduate medical students, in particular are vulnerable to experience stress. Considering the paucity of research on stress in postgraduate medical students, this study was conducted to assess their perceived stress and coping strategies. The study intends to provide inputs for future interventions to manage their stress. Objective: To study perceived stress, coping styles and psychological morbidity in postgraduate medical students Material & methods: This was a cross sectional study conducted on all postgraduate students willing to participate in the study, studying at this medical college and hospital. They were asked to fill a structured proforma to assess socio-demographic details and domains of stress. Stress was assessed by Perceived stress scale (PSS-10), coping strategies using BRIEF COPE and psychological morbidity screened by Self reporting questionnaire (SRQ). Descriptive analysis &Pearson correlation was done between stress levels, psychological morbidity and various coping strategies. Results: Postgraduate medical students had mean PSS-10 score of 17.96. Pearson correlation revealed positive correlation between stress levels measured by PSS-10 and psychological morbidity measured by SRQ (Correlation coefficient 0.639). There was also positive correlation independently between higher stress score and psychological morbidity with higher use of dysfunctional coping strategies (Correlation coefficient 0.44 & 0.421 respectively). Conclusion: Postgraduate students using dysfunctional coping strategies had higher stress and psychological morbidity, whereas those using healthy emotion focused coping strategies had lower stress levels and lower psychological morbidity.